The Application of Hospice Concepts to Neonatal Care

From the Department of Perinatology, The Children's Hospital (Drs Whitfield and Goldson and Mss Siegel, Glicken, and Powers), and the Department of Child Psychiatry, University of Colorado Health Sciences Center (Dr Harmon), Denver.

• Despite impressive improvements in outcome for infants cared for in neonatal intensive care units (NICUs), large tertiary-care referral units still admit a substantial number of infants who will not survive or, because of a predictably very poor outcome, should not be offered modern life-support techniques. Dealing with these infants can be extremely taxing on both the family and the staff. We have recently adapted the concepts first described in adult hospice care to the care of the dying neonate and his family. By providing a "Family Room" that is private yet close to the NICU and by training the staff in more supportive approaches toward these families, we have been able to deal with the problem of the dying newborn in a manner that has been beneficial to both families and staff.